Measuring the Quality of Care for Psychological Health Conditions in the Military Health System

Measuring the Quality of Care for Psychological Health Conditions in the Military Health System: Candidate Quality Measures for Posttraumatic Stress Disorder and Major Depressive Disorder

Kimberly A. Hepner
Carol P. Roth
Coreen Farris
Elizabeth M. Sloss
Grant R. Martsolf
Harold Alan Pincus
Katherine E. Watkins
Caroline Epley
Daniel Mandel
Susan D. Hosek
Carrie M. Farmer
Copyright Date: 2015
Published by: RAND Corporation
https://www.jstor.org/stable/10.7249/j.ctt15sk847
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  • Book Info
    Measuring the Quality of Care for Psychological Health Conditions in the Military Health System
    Book Description:

    To inform improvements to the quality of care delivered by the military health system for posttraumatic stress disorder and major depressive disorder, researchers developed a framework and identified, developed, and described a candidate set of measures for monitoring, assessing, and improving the quality of care. This document describes their research approach and the measure sets that they identified.

    eISBN: 978-0-8330-8659-4
    Subjects: Psychology, Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-ii)
  2. Preface
    (pp. iii-iv)
  3. Table of Contents
    (pp. v-vi)
  4. Figures and Tables
    (pp. vii-viii)
  5. Summary
    (pp. ix-xvi)

    In recent years, the number of U.S. service members treated for psychological health (PH) conditions has increased substantially. In particular, at least two PH conditions, posttraumatic stress disorder (PTSD) and major depressive disorder (MDD), have prevalence estimates ranging from 4 to 20 percent for PTSD and 5 to 37 percent for MDD (Institute of Medicine [IOM], 2013, p. 21; Ramchand, Schell, et al., 2010; Schell and Marshall, 2008). Delivering quality care to service members with these conditions is a high-priority goal for the military health system (MHS). Meeting this goal requires understanding the extent to which the care the MHS...

  6. Acknowledgments
    (pp. xvii-xviii)
  7. Abbreviations
    (pp. xix-xxii)
  8. CHAPTER ONE Introduction
    (pp. 1-6)

    Effective treatment of both physical and psychological health (PH) conditions in service members is an important part of the U.S. Department of Defense’s (DoD’s) goal of maintaining a healthy mission-ready force (Obama, 2012). Two PH conditions, posttraumatic stress disorder (PTSD) and major depressive disorder (MDD), have prevalence estimates that range from 4 to 20 percent for PTSD and 5 to 37 percent for MDD (Institute of Medicine [IOM], 2013; Ramchand, Schell, et al., 2010; Schell and Marshall, 2008). Providing evidence-based care for individuals with PTSD and MDD, which should improve patient outcomes, is a priority for the military health system...

  9. CHAPTER TWO Framework for Classifying Measures of Psychological Health Conditions
    (pp. 7-12)

    In this section, we describe a two-dimensional framework for classifying measures for PH conditions identified in the environmental scan. Using a framework for organizing existing measures on a specific topic and performing a gap analysis is recommended as the first step in the quality measure development guidelines developed by the Centers for Medicare and Medicaid Services (2014), known as the Measures Management System Blueprint. We developed the framework as a tool for gap analysis—that is, to assist us in evaluating whether the existing measures from the environmental scan address all important aspects of care for a particular PH condition....

  10. CHAPTER THREE Identification of Measures of Quality of Care for Posttraumatic Stress Disorder and Major Depressive Disorder
    (pp. 13-16)

    This chapter outlines the process by which we searched for and identified existing measures for assessing the quality of care for PTSD and MDD. Between December 2012 and March 2013, we conducted a systematic search of existing quality measures related specifically to PTSD and MDD, as well as measures that applied to patients with a range of PH conditions, including PTSD or MDD (e.g., assessment for suicide risk). The search targeted quality measure databases, measures utilized in related RAND evaluation studies, websites of individuals and organizations identified as stewards of relevant measures, and pertinent reports and CPGs published by VA...

  11. CHAPTER FOUR Overview of Candidate Sets of Measures of Care Quality for Posttraumatic Stress Disorder and Major Depressive Disorder
    (pp. 17-26)

    As discussed in Chapter Three, the selection of measures for the candidate PTSD and MDD measure sets was an iterative process. The RAND team first identified PTSD measures, MDD measures, and measures that can be applied to patients with a range of PH conditions, including PTSD and MDD, to identify existing measures that could be included in or adapted for the measure sets. Using an expert consensus process, we reviewed these measures and selected measures based on their importance, previous use of the quality measure in a military population, and the feasibility of implementation. We also adapted several MDD measures...

  12. CHAPTER FIVE Summary and Recommendations
    (pp. 27-30)

    This document described the process we followed to develop sets of candidate measures for assessing the quality of care provided for PTSD and MDD in the MHS. We reviewed 530 existing quality measures relevant to care for PTSD, MDD, and PH conditions more broadly. We selected some measures from the existing quality measures and developed or adapted others to build the measure sets. As a result of this process, we selected 29 PTSD and 29 MDD measures as candidate measures for near-term implementation by the MHS. Ten measures in the PTSD set are PTSD-specific, and ten measures in the MDD...

  13. APPENDIX A Definitions of Terms Used to Describe Quality Measures
    (pp. 31-36)
  14. APPENDIX B Descriptions of Measures of Quality of Care for Posttraumatic Stress Disorder
    (pp. 37-102)
  15. APPENDIX C Descriptions of Measures of Quality of Care for Major Depressive Disorder
    (pp. 103-164)
  16. APPENDIX D Additional Rationale for Cost Measure
    (pp. 165-178)
  17. APPENDIX E Candidate Set of Measures of Quality of Care for Posttraumatic Stress Disorder
    (pp. 179-186)
  18. APPENDIX F Candidate Set of Measures of Quality of Care for Major Depressive Disorder
    (pp. 187-194)
  19. APPENDIX G Sources of Measures
    (pp. 195-198)
  20. Bibliography
    (pp. 199-216)